D.C. Mun. Regs. tit. 29, r. 29-5008

Current through Register Vol. 71, No. 44, November 1, 2024

Rule 29-5008 - STAFFING

5008.1

Each Provider shall utilize an R.N. to manage and provide supervision to PCAs who are qualified to perform all of the functions described in Subsection 5008.3.

5008.2

Each Provider shall verify that each PCA used to deliver services, regardless of whether the PCA is an employee of the Provider or is secured through another staffing agency, meets the qualifications set forth in Section 5009.

5008.3

Each Provider shall employ an R.N. who is responsible for the following:

(a) Accepting and reviewing the beneficiary's PCA Service Authorization and initial assessment or reassessment of need for PCA services;

(b) Developing a written plan of care in accordance with Section 5005 that meets the beneficiary's assessed needs and preferences within the service limitations authorized in the PCA Service Authorization;

(c) Updating each beneficiary's written plan of care based upon subsequent reassessments of need; (d) Maintaining a clinical record in accordance with Section 5013;

(e) Reviewing the beneficiary's plan of care with each assigned PCA and ensuring that each assigned PCA has the requisite training, skills and ability to meet the beneficiary's identified needs and preferences;

(f) Monitoring the quality of PCA services on a regular basis and ensuring that PCA services are delivered in accordance with the beneficiary's Plan of Care;

(g) Supervising all PCAs, regardless of whether the PCA is an employee of the Provider or is secured through a staffing agency. Supervision shall include on-site supervision at least once every sixty (60) days;

(h) Coordinating the provision of PCA services with other home health services, as appropriate and communicating with each beneficiary's physician or APRN regarding changes in the beneficiary's condition and needs;

(i) Gathering information regarding the beneficiary's condition and the need for continued care;

(j) Communicating and coordinating with DHCF or its designated agent regarding changes in the beneficiary's condition and needs. At a minimum the Provider must communicate to DHCF or its designated agent:

(1) Any failure or inability of the provider to deliver authorized services within three (3) business days of the scheduled visit; and

(2) Any change in the beneficiary's status requiring a modification in the amount, duration, or scope of service authorized; and

(k) Counseling the beneficiary and the beneficiary's family regarding nursing and related needs.

5008.4

The R.N., at minimum, shall visit each beneficiary within forty-eight (48) hours of initiating PCA services, and no less than every sixty (60) days thereafter, to monitor the implementation of the plan of care and the quality of PCA services provided to the beneficiary.

5008.5

The R.N. shall provide additional supervisory visits to each beneficiary if the situation warrants additional visits, such as in the case of an assignment of a new personal care aide or change in the beneficiary's health status.

D.C. Mun. Regs. tit. 29, r. 29-5008

Final Rulemaking published at 50 DCR 3957 (May 23, 2003); as amended by Notice of Final Rulemaking published at 59 DCR 1760, 1773 (March 2, 2012); as amended by Final Rulemaking published at 60 DCR 15537 (November 8, 2013); amended by Final published at 63 DCR 014134 (11/18/2016)

Notice of Final Rulemaking published at 59 DCR 1760 (March 2, 2012) repealed and replaced the chapter 50 (Medicaid Reimbursement for Personal Care Services) with a new chapter 50 with the same name.

Authority: An Act to enable the District of Columbia to receive federal financial assistance under Title XIX of the Social Security Act for a medical assistance program, and for other purposes approved December 27, 1967 (81 Stat.774; D.C. Official Code § 1-307.02 (2012 Repl.)) and Section 6(6) of the Department of Health Care Finance Establishment Act of 2007, effective February 27, 2008 (D.C. Law 17-109; D.C. Official Code § 7-771.05(6) (2012 Repl.)).